Use of “Rail Technique” to Correct Thoracic Kyphosis: 2-Dimensional Operative Video

Abstract

Spondylodiscitis is an ever increasing health concern as more patients are diagnosed each year. 1,2 Despite the increased incidence, diagnosis is often delayed in many of these patients leading to potential significant deformity and secondary neurological deficits, sometimes requiring extensive surgical intervention. [2][3][4][5][6][7] Here, we present a case in which a patient had significant thoracic kyphosis due to spondylodiscitis leading to destruction of the T8 vertebral body as well as the inferior endplate of T7 and superior endplate of T9 with preservation of the posterior elements. This deformity is technically challenging to correct; therefore, we used the rail technique, similar to techniques used for posterior column subtraction, 8 but instead modified to restore the height lost from the destruction of the T8 vertebral body. This allowed us to then perform a retropleural approach to a T7-T9 corpectomy with expandable cage to complete a 360°fusion construct. The patient depicted in the video consented to the procedure as well as for images and videos from their operation to be included in educational material.